CN115209894A

CN115209894A - Method for treating APOL-1 dependent focal segmental glomerulosclerosis

Info

Publication number: CN115209894A
Application number: CN202180018304.9A
Authority: CN
Inventors: I·埃布纳; B·J·黑尔; A·W·克鲁格; N·马拉利厄; S-P·吴
Original assignee: Vertex Pharmaceuticals Inc
Current assignee: Vertex Pharmaceuticals Inc
Priority date: 2020-03-06
Filing date: 2021-03-05
Publication date: 2022-10-18
Also published as: US11801234B2; CA3173808A1; AU2021230562A1; TW202139996A; EP4114385A1; WO2021178768A1; MX2022010748A; IL296035A; KR20220151634A; US20210275496A1; US20240277661A1; BR112022017189A2; JP2023515668A

Abstract

Described herein are methods of inhibiting APOL1 and treating APOL 1-mediated diseases comprising administering Compound I and/or a pharmaceutically acceptable salt thereof.

Description

Methods of treating APOL-1 dependent focal segmental glomerulosclerosis

This application claims priority to U.S. provisional patent application 62/986,096, filed 3/6/2020, the contents of which are incorporated herein by reference in their entirety. The present disclosure relates to methods of treating an APOL 1-mediated disease, including an APOL 1-mediated kidney disease such as APOL 1-mediated Focal Segmental Glomerulosclerosis (FSGS) and/or APOL 1-mediated non-diabetic kidney disease (NDKD), comprising administering compound I, a pharmaceutically acceptable salt thereof, and/or a deuterated derivative of compound I or a salt thereof. The present disclosure also provides pharmaceutical compositions comprising a therapeutic amount of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

NDKD is a kidney disease involving damage to podocytes or the glomerular vascular bed that is not attributable to diabetes. FSGS is a rare kidney disease with an estimated global incidence of 0.2 to 1.1/100,000/year. FSGS and NDKD are caused by injury to podocytes, which are part of the glomerular filtration barrier, resulting in proteinuria. Proteinuria patients are at higher risk of developing end-stage renal disease (ESKD) and proteinuria-related complications such as infection or thromboembolic events. There is no standardized treatment regimen for FSGS or NDKD, nor is there an approved drug. Current treatment options for FSGS and proteinuria patients include high doses of corticosteroids, which will induce remission of proteinuria in a small number of patients. Current treatment options for NDKD are based on blood pressure control and blockade of the renin angiotensin system.

FSGS and NDKD can be divided into different subgroups based on underlying etiology. One homogenous subgroup of FSGS is characterized by the presence of independent common sequence variants called G1 and G2 in the apolipoprotein L1 (APOL 1) gene, which are referred to as "APOL1 risk alleles". G1 encodes a pair of related non-synonymous amino acid changes (S342G and I384M), G2 encodes a deletion of 2 amino acids near the C-terminus of the protein (N388 del: Y389 del), and G0 is the ancestor (low risk) allele. A unique phenotype of NDKD was also found in patients with APOL1 genetic risk variants. In both the APOL 1-mediated FSGS and NDKD, a higher degree of proteinuria and a faster rate of renal function loss occurred in patients with both risk alleles compared to the same disease patients without or with only 1 genetic risk variant of APOL 1.

The APOL1 gene is expressed in various organs of humans, including the liver and kidney. APOL1 can prevent parasitic infections caused by trypanosoma brucei (t.b. APOL1 is endocytosed by trypanosoma brucei and transported to lysosomes where it inserts into the lysosomal membrane and forms pores that lead to parasite swelling and death. While all 3 APOL1 variants (G0, G1 and G2) have the ability to lyse trypanosoma brucei, the APOL 1G 1 and G2 variants provide additional protection against parasite species that have evolved serum resistance associated proteins (SRAs) that inhibit APOL 1G 0; these species can cause lethargy. G1 and G2 variants evade inhibition by SRA; g1 provides additional protection for t.b. gambiense (which causes western non-comatose), while G2 provides additional protection for t.b. rhodoesense (which causes eastern non-comatose).

In the kidney, APOL1 is expressed in podocytes, endothelial cells (including glomerular endothelial cells) and some tubular cells. Podocyte-specific expression of APOL 1G 1 or G2 (but not G0) in transgenic mice induces structural and functional changes including proteinuria, reduced renal function, podocyte abnormalities, and glomerulosclerosis. Consistent with these data, G1 and G2 variants of APOL1 play causal roles in inducing FSGS and accelerating its progression in humans. Individuals with an APOL1 risk allele (i.e., either homozygote or compound heterozygote of the APOL 1G 1 or APOL 1G 2 allele) are at increased risk for developing FSGS, and if they develop FSGS, they will be at risk for a rapid decline in renal function. Thus, inhibition of APOL1 may have a positive impact on individuals carrying an APOL1 risk allele.

3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] -N- [ (3S, 4R) -4-hydroxy-2-oxo-pyrrolidin-3-yl ] propanamide (Compound I) is a small molecule inhibitor of APOL 1-induced cell death and APOL 1-induced Trypanosoma brucei lysis. Compound I can be depicted as having the following structure:

compound I, its preparation and physicochemical data are disclosed in co-pending U.S. application No. 16/717,099 and PCT international application No. PCT/US2019/066746 (disclosed as "compound 2"), both of which are incorporated herein by reference for the present disclosure.

The present disclosure provides methods of inhibiting APOL 1-induced cell death and treating APOL 1-mediated diseases, including APOL 1-mediated kidney diseases such as FSGS and/or NDKD, by administering a pharmaceutical composition comprising a therapeutically effective amount of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative of compound I. The methods and pharmaceutical compositions disclosed herein provide treatment for subjects with APOL 1-mediated kidney disease associated with one or more APOL1 risk alleles and with or without proteinuria (i.e., a protein to creatinine ratio > 3g/g for subjects with nephropathy range proteinuria; a protein to creatinine ratio > 0.15g/g to < 3.0g/g for subjects with nephropathy range proteinuria). The methods and pharmaceutical compositions disclosed herein provide treatment for individuals with an APOL 1-mediated kidney disease associated with one or more APOL1 risk alleles, with or without nephrorange proteinuria.

In some embodiments, the disclosure relates to pharmaceutical compositions comprising a therapeutically effective amount of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative of compound I.

In some embodiments, the present disclosure relates to pharmaceutical compositions comprising compound I, deuterated derivatives of compound I and/or pharmaceutically acceptable salts of compound I or deuterated derivatives of compound I, which compositions may further comprise at least one additional active pharmaceutical ingredient and/or at least one carrier. In some embodiments, the present disclosure provides methods of treating an APOL 1-mediated kidney disease, including FSGS and/or NDKD, comprising administering to a subject in need thereof compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative of compound I, optionally as part of a pharmaceutical composition comprising at least one additional active ingredient.

Drawings

Figure 1 depicts the XRPD diffractogram of compound I form a.

FIG. 2 depicts the solid state of Compound I form A ¹³ C NMR spectrum.

Definition of

As used throughout this disclosure, "compound I" refers to 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] -N- [ (3s, 4 r) -4-hydroxy-2-oxo-pyrrolidin-3-yl ] propionamide, which may be depicted as having the structure:

compound I may be in the form of a deuterated derivative or a pharmaceutically acceptable salt of the compound or deuterated derivative. In some embodiments, compound I is administered in crystalline or substantially pure crystalline form a.

As used herein, the term "APOL1" means an apolipoprotein L1 protein and the term "APOL1" means an apolipoprotein L1 gene.

As used herein, the term "FSGS" means focal segmental glomerulosclerosis, a podocyte (glomerular visceral epithelial cell) disease that causes progressive decline in proteinuria and renal function and is associated with 2 common genetic variants of APOL1 (G1: S342G: I384M and G2: N388del: Y389 del).

As used herein, the term "NDKD" means a non-diabetic renal disease that is a renal disease involving damage to podocytes or glomerular vascular beds not attributable to diabetes and that is associated with 2 common genetic variants of APOL1 (G1: S342G: I384M and G2: N388del: Y389 del). This includes, but is not limited to, hypertensive kidney disease, lupus, minimal change nephropathy, membranous nephropathy, steroid resistant or steroid sensitive nephropathy syndrome, and allograft kidney transplant dysfunction. In some embodiments, it includes chronic kidney disease in a non-diabetic patient with hypertension and proteinuria ≧ 0.2g/g but excludes chronic kidney disease caused by an infection, malignancy, obstructive or autoimmune disorder.

The terms "patient" and "subject" are used interchangeably and refer to an animal, including a human.

As used herein, the term "treating" or "treatment" generally means amelioration of an APOL 1-mediated disease, including amelioration of an APOL 1-mediated renal disease such as, but not limited to, FSGS and/or NDKD, or amelioration of one or more symptoms, and/or lessening the severity of FSGS and/or NDKD or one or more symptoms thereof in a subject. As used herein, "treatment" and its cognates include, but are not limited to, the following: complete or partial remission, reducing the risk of renal failure (e.g., ESRD) and disease-related complications (e.g., edema, susceptibility to infection, or thromboembolic events). Improvement in any of these symptoms or reduction in their severity can be readily assessed according to methods and techniques known in the art or subsequently developed.

As used herein, a "therapeutically effective" amount of compound I refers to an amount of compound I, a deuterated derivative of compound 1, or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof that produces the desired effect of its administration (e.g., ameliorating symptoms of APOL 1-mediated kidney disease, reducing the severity of APOL 1-mediated kidney disease or symptoms of APOL 1-mediated kidney disease, and/or reducing the progression of symptoms of APOL 1-mediated kidney disease or APOL 1-mediated kidney disease, ameliorating symptoms of FSGS and/or NDKD, reducing the severity of FSGS and/or NDKD or symptoms of FSGS and/or NDKD, and/or slowing or reducing the progression of FSGS and/or NDKD or symptoms of FSGS and/or NDKD). The exact amount of a therapeutically effective dose will depend on The purpose of The treatment and will be determined by one of skill in The Art using known techniques (see, e.g., lloyd (1999) The Art, science and Technology of Pharmaceutical Compounding). In some embodiments, a therapeutically effective dose of compound I is 2mg to 250mg. Other suitable therapeutically effective doses are disclosed herein.

As used herein, "ULN" means "upper normal limit".

As used herein, the term "in combination with" when referring to two or more compounds, agents or additional active pharmaceutical ingredients means that the two or more compounds, agents or active pharmaceutical ingredients are administered to a patient before, simultaneously with or after each other.

In reference to a compound of the present disclosure, the term "compound" refers to a collection of molecules having the same chemical structure except that isotopic variations may exist between the constituent atoms of the molecules, unless otherwise specified as a collection of stereoisomers (e.g., a collection of racemates, a collection of cis/trans stereoisomers, or a collection of (E) and (Z) stereoisomers). Thus, it will be clear to those skilled in the art that compounds represented by particular chemical structures containing the indicated deuterium atoms will also contain lesser amounts of isotopologues having hydrogen atoms at one or more designated deuterium positions in the structure. The relative amounts of such isotopologues in the compounds of the present disclosure will depend on a number of factors, including the isotopic purity of the reagents used to prepare the compounds and the incorporation efficiency of the isotopes in the various synthetic steps used to prepare the compounds. However, as set forth above, the relative amount of all such isotopologues will be less than 49.9% of the compound. In other embodiments, the relative amount of all such isotopologues will be less than 47.5%, less than 40%, less than 32.5%, less than 25%, less than 17.5%, less than 10%, less than 5%, less than 3%, less than 1%, or less than 0.5% of the compound.

As used herein, the terms "crystalline form" and "form" interchangeably refer to a crystal structure (or polymorph) having a particular arrangement of molecules in a lattice. The crystalline forms can be identified and distinguished from each other by one or more characterization techniques, including, for example, X-ray powder diffraction (XRPD), single crystal X-ray diffraction, and Solid State Nuclear Magnetic Resonance (SSNMR). Thus, as used herein, the term "crystalline form a of compound I" refers to a unique crystalline form that can be identified and distinguished from each other by any one or more characterization techniques (including, for example, XRPD, single crystal X-ray diffraction, and SSNMR). In some embodiments, compound I crystalline form a is characterized by an X-ray powder diffraction pattern having one or more signals at one or more specified 2 Θ values (° 2 Θ).

As used herein, the term "SSNMR" refers to an analytical characterization method of solid state nuclear magnetic resonance. SSNMR spectra of any magnetically active isotope present in the sample can be recorded at ambient conditions. Typical examples of active isotopes of small molecule active pharmaceutical ingredients include ¹ H、 ² H、 ¹³ C、 ¹⁹ F、 ³¹ P、 ¹⁵ N、 ¹⁴ N、 ³⁵ Cl、 ¹¹ B、 ⁷ Li、 ¹⁷ O、 ²³ Na、 ⁷⁹ Br and ¹⁹⁵ Pt。

as used herein, the term "XRPD" refers to the analytical characterization method of X-ray powder diffraction. XRPD patterns can be recorded in transmission or reflection geometry under ambient conditions using a diffractometer.

As used herein, the terms "X-ray powder diffraction pattern", "XRPD pattern", and "XRPD pattern" refer interchangeably to a pattern of experimentally obtained plotted signal position (on the abscissa) versus signal intensity (on the ordinate). For amorphous materials, the X-ray powder diffraction pattern may include one or more broad signals; whereas for crystalline materials, the X-ray powder diffraction pattern may comprise one or more signals, each signal being identified by its angle value measured in 2 θ degrees (° 2 θ), depicted on the abscissa of the X-ray powder diffraction pattern, which may be expressed as "a signal at · 2 θ", "a signal at 2 θ values of.... And/or" a signal at least.. Times 2 θ values selected from.... Once ".

As used herein, "signal" or "peak" refers to the point in an XRPD pattern where the intensity measured in counts is at a local maximum. One of ordinary skill in the art will recognize that one or more signals (or peaks) in an XRPD pattern may overlap and may be, for example, not apparent to the naked eye. Indeed, one of ordinary skill in the art will recognize that some industry recognized methods are capable of and suitable for determining whether a signal is present in a pattern, such as Rietveld refinement.

As used herein, "a signal at a2 Θ value of. ·...," a signal at a2 Θ value of..., "and/or" a signal at least one 2 Θ value selected from.... Refers to an X-ray reflection position (° 2 Θ) as measured and observed in an X-ray powder diffraction experiment.

The repeatability of the angle values is within 0.2 ° 2 θ, i.e., the angle values can be at the recited angle value +0.2 ° 2 θ, angle value-0.2 ° 2 θ, or at any value between the two endpoints (angle value +0.2 ° 2 θ and angle value-0.2 ° 2 θ).

The terms "signal intensity" and "peak intensity" refer interchangeably to the relative signal intensity within a given X-ray powder diffraction pattern. Factors that may affect the relative signal or peak intensity include sample thickness and preferred orientation (e.g., the crystalline particles are not randomly distributed).

As used herein, the term "X-ray powder diffraction pattern having a signal at 2 Θ values of.

As used herein, an X-ray powder diffraction pattern is "substantially similar to that in a [ particular ] diagram" when at least 90% (e.g., at least 95%, at least 98%, or at least 99%) of the signals in the two diffraction patterns overlap. In determining "substantial similarity," one of ordinary skill in the art will appreciate that there may be variations in intensity and/or signal position in the XRPD diffraction pattern even for the same crystalline form. Thus, it will be understood by those of ordinary skill in the art that the maximum value of the signal in the XRPD diffractogram, referred to herein as 2 θ degrees (° 2 θ), generally means that the value reports the reported value ± 0.2 ° 2 θ, which is an art-recognized variance.

As used herein, an SSNMR spectrum is "substantially similar to that in a [ particular ] diagram" when at least 90% (e.g., at least 95%, at least 98%, or at least 99%) of the signals in the two spectra overlap. In determining "substantial similarity," one of ordinary skill in the art will appreciate that there may be variations in intensity and/or signal position in the SSNMR spectrum even for the same crystalline form. Thus, it will be understood by those of ordinary skill in the art that reference herein to a signal maximum (in ppm) in an SSNMR spectrum generally means that the value reports the reported value ± 0.2ppm, which is an art-recognized variance.

As used herein, a crystalline form is "substantially pure" when it is present in an amount equal to or greater than 90% by weight of the total of all solid forms in the sample as determined by methods in the art, such as quantitative XRPD. In some embodiments, a solid form is "substantially pure" when it constitutes 95% or more by weight of the amount of the total of all solid forms in a sample. In some embodiments, a solid form is "substantially pure" when it constitutes equal to or greater than 99% by weight of the amount of the total of all solid forms in a sample.

As used herein, the term "pharmaceutically acceptable salt" refers to a salt form of a compound of the present disclosure, wherein the salt is non-toxic. Pharmaceutically acceptable salts of the compounds of the present disclosure include those derived from suitable inorganic and organic acids and bases. Pharmaceutically acceptable salts are well known in the art. For example, pharmaceutically acceptable salts are described in detail in J.pharmaceutical Sciences,1977, 66,1-19, S.M.Berge et al.

Suitable pharmaceutically acceptable salts are, for example, those disclosed in S.M. Berge et al, J.pharmaceutical Sciences,1977, 66, 1-19. For example, table 1 of the below-loaded article provides the following pharmaceutically acceptable salts.

TABLE 1 exemplary pharmaceutically acceptable salts

Non-limiting examples of pharmaceutically acceptable acid addition salts include: a salt with an inorganic acid such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid, or perchloric acid; salts with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid, or malonic acid; and salts formed by using other methods used in the art such as ion exchange. Non-limiting examples of pharmaceutically acceptable salts include adipates, alginates, ascorbic acid, aspartates, benzenesulfonates, benzoates, bisulfates, borates, butyrates, camphorates, camphorsulfonates, citrates, cyclopentanepropionates, digluconates, dodecylsulfates, ethanesulfonates, formates, fumarates, glucoheptonates, glycerophosphates, gluconates, hemisulfates, heptanoates, hexanoates, hydroiodiates, 2-hydroxy-ethanesulfonates, lactobionates, lactates, laurates, lauryl sulfates, malates, maleates, malonates, methanesulfonates, 2-naphthalenesulfonates, nicotinates, nitrates, oleates, oxalates, palmitates, pamoate, pectinates, persulfates, 3-phenylpropionates, phosphates, picrates, pivalates, propionates, stearates, succinates, sulfates, tartrates, thiocyanates, p-toluenesulfonates, undecanoates, and valeric acid salts. Pharmaceutically acceptable salts derived from suitable bases include alkali metal salts, alkaline earth metal salts, ammonium salts and N ⁺ (C _1-4 Alkyl radical) ₄ And (3) salt. The present disclosure also contemplates the quaternization of any basic nitrogen-containing groups of the compounds disclosed herein. Suitable non-limiting examples of alkali and alkaline earth metal salts include sodium, lithium, potassium, calcium, and magnesium. Other non-limiting examples of pharmaceutically acceptable salts include ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, lower alkyl sulfonates, and aryl sulfonates. Other suitable non-limiting examples of pharmaceutically acceptable salts include benzenesulfonate and glucosamine salts.

As used herein, "deuterated derivative of compound I" refers to a form of compound I in which at least one hydrogen has been replaced with a deuterium atom. It will be appreciated that some variation in the abundance of natural isotopes will occur in the synthesized compounds depending on the source of the chemical materials used in the synthesis. Despite this variation, the concentration of the naturally abundant stable hydrogen isotope is small and inconsequential compared to the degree of substitution of the stable isotope by the deuterated derivative described herein. Thus, unless otherwise indicated, in referring to a "deuterated derivative" of a compound of the present disclosure, at least one hydrogen is replaced with deuterium well above its natural isotopic abundance (typically about 0.015%). In some embodiments, deuterated derivatives of the present disclosure have an isotopic enrichment factor for each deuterium atom of at least 3500 (52.5% deuterium incorporation at each designated deuterium), at least 4500 (67.5% deuterium incorporation), at least 5000 (75% deuterium incorporation), at least 5500 (82.5% deuterium incorporation), at least 6000 (90% deuterium incorporation), at least 6333.3 (95% deuterium incorporation), at least 6466.7 (97% deuterium incorporation), or at least 6600 (99% deuterium incorporation).

As used herein, the term "isotopic enrichment factor" means the ratio between the isotopic abundance and the natural abundance of a given isotope.

In some embodiments, the disclosure also relates to methods of treatment using isotopically-labeled compounds of compound I (which in some embodiments are referred to as compound I), or pharmaceutically acceptable salts thereof, wherein the formulae and variables of such compounds and salts are each and independently as described above or in any other embodiment above, with the proviso that one or more atoms therein have been replaced with an atom(s) having an atomic mass or mass number different from the atomic mass or mass number of the atom(s) usually naturally occurring (isotopically-labeled). Examples of commercially available isotopes that are suitable for the present disclosure include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, fluorine and chlorine, each for example ² H、 ³ H、 ¹³ C、 ¹⁴ C、 ¹⁵ N、 ¹⁸ O、 ¹⁷ O、 ³¹ p、 ³² p、 ³⁵ S、 ¹⁸ F and ³⁶ Cl。

isotopic labellingThe compounds and salts of (a) can be used in a variety of beneficial ways. They may be suitable for use in drugs and/or various types of assays, such as substrate tissue distribution assays. For example, tritium (A) ³ H) And/or carbon-14 ( ¹⁴ C) The labeled compounds are particularly useful in various types of assays, such as substrate tissue distribution assays, due to their relative simplicity of preparation and excellent detectability. For example, deuterium ( ² H) The labeled compounds are therapeutically useful and are compared to non-labeled compounds ² H-labelled compounds have potential therapeutic advantages. In general, deuterium (D) is compared to the non-isotopically labeled compounds and salts ² H) Labeled compounds and salts may have higher metabolic stability due to the kinetic isotope effects described below. Higher metabolic stability translates directly into increased in vivo half-life or lower doses, which may be desirable. Isotopically labeled compounds and salts can generally be prepared by carrying out the procedures disclosed in the synthetic schemes and related descriptions, examples sections and preparations herein to replace a non-isotopically labeled reactant with a readily available isotopically labeled reactant.

In some embodiments of the present invention, the substrate is, isotopically labelled the compounds and salts being deuterium ( ² H) Labeled compounds and salts. In some embodiments, isotopically labeled compounds and salts are deuterated (I), (II), (III), (IV), and (IV) ² H) A label in which one or more hydrogen atoms have been replaced with deuterium. In the chemical structure, deuterium is represented as "D".

By first order kinetic isotope effect, deuterium: (1) ² H) Labeled compounds and salt to non-deuterium (C) ² H) The labeled compound or salt may undergo an altered oxidative metabolic rate. First order kinetic isotopic effects are changes in the rate of chemical reactions caused by nuclear exchange of isotopes, which in turn are caused by changes in the ground state energy necessary to form covalent bonds after the isotope exchange. The exchange of heavier isotopes generally leads to a reduction in the ground state energy of the chemical bonds and hence to a reduction in the cleavage of rate-limiting bonds. The product distribution ratio can vary significantly if bond breakage occurs in or near the saddle point region along the coordinates of the multi-product reaction. For example, if deuterium is bonded to a carbon atom at an exchangeable position,then k is _M /k _D A rate difference of =2-7 is typical. For further discussion, see s.l.harbeson and r.d.tung, deuterium In Drug Discovery and Development, ann.rep.med.chem.2011, 46, 403-417, which are incorporated herein by reference In their entirety.

The terms "about" and "approximately" when used in conjunction with a dose, amount, or weight percentage of an ingredient of a composition or dosage form includes a value for the specified dose, amount, or weight percentage or a range of such dose, amount, or weight percentage that one of ordinary skill in the art would consider to provide a pharmacological effect equivalent to that obtained from the specified dose, amount, or weight percentage. The terms "about" and "approximately" may refer to an acceptable error for a particular value as determined by one of ordinary skill in the art, which will depend in part on how the value is measured or determined. In some embodiments, the terms "about" and "approximately" mean within 20%, 15%, 10%, 5%, 4%, 3%, 2%, 1%, or 0.5% of a given value or range.

One of ordinary skill in the art will recognize that when disclosing the amount of a "compound or deuterated derivative thereof or pharmaceutically acceptable salt of a compound or deuterated derivative thereof," the amount of the pharmaceutically acceptable salt form of the compound is an amount equivalent to the concentration of the free base of the compound or deuterated derivative thereof. It is noted that the amount of a compound disclosed herein, or a pharmaceutically acceptable salt thereof, is in its free base form. For example, "100mg of at least one compound selected from compound I and pharmaceutically acceptable salts thereof" includes 100mg of compound I and a pharmaceutically acceptable salt of compound I at a concentration equal to 100mg of compound I.

As used herein, the "daily" amount of compound I or a deuterated derivative thereof or a pharmaceutically acceptable salt thereof administered refers to the total amount administered during the day, but does not limit the frequency of administration per day. The daily amount administered to the patient may be administered one or more times a day, such as twice or three times a day (where each of the multiple administrations comprises administering an amount of compound I or a deuterated derivative thereof or a pharmaceutically acceptable salt thereof that is less than the "daily" amount, whereas the "daily" amount refers to the total amount administered in the day). Each administration of compound I or a deuterated derivative thereof or a pharmaceutically acceptable salt thereof can consist of administering compound I or a deuterated derivative thereof or a pharmaceutically acceptable salt thereof in the form of a single composition (e.g., a single dose, such as a single tablet or a single capsule) or in the form of multiple compositions (e.g., multiple doses, such as multiple (i.e., two or more) tablets and/or capsules).

In some embodiments, compound I used in the methods and compositions of the present invention is crystalline form a. In some embodiments, compound I is substantially pure crystalline form a. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern substantially similar to that in figure 1. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least two 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least three 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least four 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least five 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least six 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least seven 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least eight 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern at the following 2 Θ values: signals are provided at 9.5 +/-0.2, 13.2 +/-0.2, 14.4 +/-0.2, 19.2 +/-0.2, 19.5 +/-0.2, 19.8 +/-0.2, 26.3 +/-0.2, 26.7 +/-0.2 and 28.6 +/-0.2.

In some embodiments, compound I form a used in the methods and compositions of the present invention is characterized by an X-ray powder diffraction pattern having a signal at least one 2 value selected from the group consisting of 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, 28.6 ± 0.2, 29.1 ± 0.2 and 29.5 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having a signal at least two 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, 28.6 ± 0.2, 29.1 ± 0.2, and 29.5 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least three 2 values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, 28.6 ± 0.2, 29.1 ± 0.2, and 29.5 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having a signal at least four 2 values selected from the group consisting of 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, 28.6 ± 0.2, 29.1 ± 0.2, and 29.5 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least five 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having a signal at least six 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least seven 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having signals at least eight 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having a signal at least nine 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2. In some embodiments, compound I form a is characterized by an X-ray powder diffraction pattern having a signal at least ten 2 Θ values selected from 9.5 ± 0.2, 13.2 ± 0.2, 14.4 ± 0.2, 16.1 ± 0.2, 17.7 ± 0.2, 18.8 ± 0.2, 19.2 ± 0.2, 19.5 ± 0.2, 19.8 ± 0.2, 20.7 ± 0.2, 21.4 ± 0.2, 21.7 ± 0.2, 22.4 ± 0.2, 22.9 ± 0.2, 23.3 ± 0.2, 24.0 ± 0.2, 26.3 ± 0.2, 26.7 ± 0.2, 27.1 ± 0.2, 27.7 ± 0.2, and 28.6 ± 0.2.

In some embodiments, compound I used in the methods and compositions of the present invention is compound I form a. In some embodiments, compound I used in the methods and compositions of the present invention is in substantially pure form a.

In some embodiments, compound I form a used in the methods and compositions of the present invention is characterized by ¹³ The C NMR spectrum has a signal at least one ppm value selected from 178.7. + -. 0.2ppm, 154.4. + -. 0.2ppm, 127.8. + -. 0.2ppm, 125.2. + -. 0.2ppm, 102.0. + -. 0.2ppm, 59.3. + -. 0.2ppm, 38.9. + -. 0.2ppm and 24.4. + -. 0.2 ppm. In some embodiments, compound I form a is characterized by ¹³ The C NMR spectrum has signals at least two ppm values selected from 178.7. + -. 0.2ppm, 154.4. + -. 0.2ppm, 127.8. + -. 0.2ppm, 125.2. + -. 0.2ppm, 102.0. + -. 0.2ppm, 59.3. + -. 0.2ppm, 38.9. + -. 0.2ppm and 24.4. + -. 0.2 ppm. In some embodiments, compound I form a is characterized by ¹³ The C NMR spectrum has signals at least three ppm values selected from 178.7. + -. 0.2ppm, 154.4. + -. 0.2ppm, 127.8. + -. 0.2ppm, 125.2. + -. 0.2ppm, 102.0. + -. 0.2ppm, 59.3. + -. 0.2ppm, 38.9. + -. 0.2ppm and 24.4. + -. 0.2 ppm. In some embodiments, compound I form a is characterized by ¹³ The C NMR spectrum has signals at least four ppm values selected from 178.7. + -. 0.2ppm, 154.4. + -. 0.2ppm, 127.8. + -. 0.2ppm, 125.2. + -. 0.2ppm, 102.0. + -. 0.2ppm, 59.3. + -. 0.2ppm, 38.9. + -. 0.2ppm and 24.4. + -. 0.2 ppm. In some embodiments, compound I form a is characterized by ¹³ The C NMR spectrum had signals at 178.7. + -. 0.2ppm, 154.4. + -. 0.2ppm, 127.8. + -. 0.2ppm, 125.2. + -. 0.2ppm, 102.0. + -. 0.2ppm, 59.3. + -. 0.2ppm, 38.9. + -. 0.2ppm and 24.4. + -. 0.2 ppm.

In some embodiments, compound I is a substantially crystalline solid. In some embodiments, the crystalline solid consists of form a in an amount of 75% to 99% relative to the total weight of the crystalline solid compound I. In some embodiments, the crystalline solid consists of form a in an amount of 80% to 99% relative to the total weight of crystalline solid compound I. In some embodiments, the crystalline solid consists of form a in an amount of 85% to 99% relative to the total weight of the crystalline solid compound I. In some embodiments, the crystalline solid consists of form a in an amount of 90% to 99% relative to the total weight of crystalline solid compound I. In some embodiments, the crystalline solid consists of form a in an amount of 95% to 99% relative to the total weight of crystalline solid compound I.

In some embodiments, the present disclosure provides methods of treating an APOL 1-mediated disease with compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered daily. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily or multiple times daily, such as twice daily or three times daily. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered twice daily. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered three times per day.

In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered as a single composition. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof are administered in multiple compositions (e.g., as multiple tablets and/or multiple pills per administration). Thus, in some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily as a single composition. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily as multiple compositions that are administered simultaneously.

In some embodiments, a therapeutically effective amount of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered at a daily dose of 2mg to 250mg, 5mg to 200mg, 10mg to 150mg, 15mg to 100mg, 20mg to 80mg, or 25mg to 75 mg. In certain embodiments, a therapeutically effective amount of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered at a daily dose of 15mg to 30mg, 15mg to 45mg, 15mg to 60mg, 15mg to 75mg, 30mg to 45mg, 30mg to 60mg, or 30mg to 75 mg.

In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily, twice daily, or three times daily, in a total daily amount of 2mg to 250mg, 5mg to 200mg, 10mg to 150mg, 15mg to 100mg, 20mg to 80mg, 25 to 75mg, 30 to 60mg, or 15mg to 45 mg. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, 95mg, or 100mg once daily, twice daily, or three times daily. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily in an amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg per day. In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered twice daily in an amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg twice daily, i.e., compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg daily (i.e., the total amount per day) divided by two parts (which may be equal or unequal) per day. Reference to administering compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof in an amount "twice daily" refers to administering an amount of compound I, compound I form a, a deuterated derivative thereof, or a pharmaceutically acceptable salt thereof twice a day, wherein each of the two administrations comprise administering an amount of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof that is less than the amount per day, but wherein the sum of these amounts administered in one day equals the amount per day.

In some embodiments, compound I form a, the deuterated derivative of compound I, and/or the pharmaceutically acceptable salt of compound I or the deuterated derivative thereof is administered once every 8 hours ("q 8 h"), every 12 hours ("q 12 h"), or every 24 hours ("q 24 h"). In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered every 8 hours (q 8 h). In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once every 12 hours (q 12 h). In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once every 24 hours (q 24 h).

In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, or 75mg once every 12 hours (q 12 h).

In some embodiments, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg once every 24 hours (q 24 h). In some embodiments, compound I form a, the deuterated derivative of compound I, and/or the pharmaceutically acceptable salt thereof is administered in an amount of 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, or 80mg once every 24 hours (q 24 h).

In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 15mg once every 24 hours (q 24 h). In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 30mg once every 24 hours (q 24 h). In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 45mg once every 24 hours (q 24 h). In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 60mg once every 24 hours (q 24 h). In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in an amount of 75mg once every 24 hours (q 24 h).

In some embodiments, compound I form a is administered in an amount of 15mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 30mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 45mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 60mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 75mg once every 24 hours (q 24 h).

In some embodiments, compound I form a is administered in an amount of 15mg to 30mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 30mg to 45mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 45mg to 60mg once every 24 hours (q 24 h). In some embodiments, compound I form a is administered in an amount of 60mg to 75mg once every 24 hours (q 24 h).

In some embodiments, the present disclosure provides pharmaceutical compositions comprising compound I, compound I form a, deuterated derivatives of compound I, and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof, which may further comprise at least one additional active pharmaceutical ingredient and/or at least one carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising at least one compound selected from the group consisting of: compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier.

Compound I, compound I form a, deuterated derivatives of compound I and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof can be administered in a single pharmaceutical composition or in separate pharmaceutical compositions. Such pharmaceutical compositions may be formulated for administration once daily (i.e., every 24 hours (q 24 h)) or multiple times daily, such as twice or three times daily.

In some embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with one or more other therapeutic agents. In some embodiments, the additional therapeutic agent is selected from the group consisting of an Angiotensin Converting Enzyme (ACE) inhibitor, an Angiotensin Receptor Blocker (ARB), an enkephalinase inhibitor, a sodium-glucose cotransporter-2 (SGLT 2) inhibitor, a renin inhibitor, an immunosuppressive agent such as tacrolimus, mycophenolate, cyclosporine, or a systemic corticosteroid such as prednisone or a prednisone equivalent, and a mineralocorticoid receptor antagonist. In some embodiments, the additional therapeutic agent is selected from the group consisting of an Angiotensin Converting Enzyme (ACE) inhibitor, an Angiotensin Receptor Blocker (ARB), a sodium-glucose cotransporter 2 (SGLT 2) inhibitor, a renin inhibitor, an enkephalinase inhibitor, and a systemic corticosteroid (e.g., prednisone or a prednisone equivalent). In certain embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with an ACE inhibitor (ACEi) and an ARB. In certain embodiments, compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with an ACE inhibitor (ACEi), an ARB, and prednisone or a prednisone equivalent.

As used herein, the term "angiotensin converting enzyme inhibitor" or "ACE inhibitor" refers to a class of drugs, such as small molecule organic chemical compounds (1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA), or conjugates combining any two or more of the foregoing, that block the formation of the native chemical angiotensin I that narrows blood vessels, resulting in relaxation of blood vessels and reduction of blood, which results in lower blood pressure and reduced oxygen demand by the heart. Non-limiting examples of ACE inhibitors include lisinopril

Lisinopril and hydrochlorothiazide

Benazepril (Lotensin), captopril (Capoten), enalapril

Zofenopril, perindopril

Trandolapril

Quinapril

And ramipril

As used herein, the term "angiotensin receptor blocker" or "ARB" refers to a class of drugs, such as substances such as small molecule organic chemical compounds (≦ 1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA), or conjugates combining any two or more of the foregoing, that block the effects of angiotensin I that narrow blood vessels (not blocking formation as ACE inhibitors) resulting in relaxation of blood vessels and reduction of blood, which results in lower blood pressure and reduced oxygen demand of the heart. Non-limiting examples of ARBs include losartan

Irbesartan

Olmesartan medoxomil

Telmisartan

Candesartan

Valsartan

Fimasartan and azilsartan

Eprosartan and losartan potassium-hydrochlorothiazide

As used herein, the term "renin inhibitor" refers to a class of drugs, such as substances, such as small molecule organic chemical compounds (< 1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA) or conjugates combining any two or more of the foregoing, that slow the production of renin, an enzyme produced by the kidney that initiates a series of blood pressure increasing responses, including the production of angiotensin I. The first approved drug in this class is aliskiren

Aliskiren cannot be taken without ACE inhibitors or ARBs due to the risk of serious complications, including stroke.

As used herein, the term "enkephalinase inhibitor" refers to a class of drugs, such as substances, such as small molecule organic chemical compounds (< 1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA), or conjugates combining any two or more of the foregoing, that prevent the activity of enkephalinase on signaling peptides such as enkephalin, substance P, endothelin, atrial natriuretic peptide. Enkephalinase, which is a zinc-dependent metalloprotease that is expressed in many types of tissues, but is particularly abundant in the kidney, cleaves and inactivates several peptide hormones, including glucagon, enkephalin, substance P, neurotensin, oxytocin, and bradykinin. Non-limiting examples of enkephalinase inhibitors include Sacubitril/valsartan (Entresto/LCZ 696), sacubitril (AHU-377), sacubitril (LBQ 657), RB-101, UK-414, UK-495, opatralia, ecadotril, and Canshaqu.

As used herein, the term "sodium-glucose cotransporter 2 inhibitor" or "SGLT2 inhibitor" refers to a class of drugs, such as substances, e.g., small molecule organic chemical compounds (≦ 1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA), or conjugates combining any two or more of the foregoing, that have activity for inhibiting sodium-glucose transporter 2 (SGLT 2). Non-limiting examples of SGLT2 inhibitors include engagliflozin

Canagliflozin

Dapagliflozin

Rueglin (including Rueglin Eicosa BHV091009, ieglin IASP-1941 or

) HM41322, begliflozin, egliflozin

Suogelijing, luogelijing and tuogelijing

Escitalopram carbonate or a pharmaceutically acceptable salt of any of the foregoing. Further examples of SGLT2 inhibitors are described in WO01/027128, WO04/013118, WO04/080990, EP1852439A1, WO01/27128, WO03/099836, WO2005/092877, WO2006/034489, WO2006/064033, WO2006/117359, WO2006/117360, WO2007/025943, WO2007/028814, WO2007/031548, WO2007/093610, WO2007/128749, WO2008/049923, WO2008/055870, and WO2008/055940, each of which is incorporated herein by reference in its entirety.

As used herein, the term "systemic corticosteroid" refers to corticosteroids administered orally or by injection, and does not include corticosteroids used in the eye, ear or nose and on the skin. Non-limiting examples of systemic corticosteroids include prednisone or prednisone equivalents (e.g., prednisolone, methylprednisolone), beclomethasone, betamethasone, dexamethasone, hydrocortisone, and triamcinolone.

As used herein, the term "mineralocorticoid receptor antagonist" refers to a class of drugs, such as substances, such as small molecule organic chemical compounds (1 kDa) or large biomolecules such as peptides (e.g., soluble peptides), proteins (e.g., antibodies), nucleic acids (e.g., siRNA), or conjugates combining any two or more of the foregoing, that have activity to antagonize the effect of aldosterone, a mineralocorticoid receptor. The small molecule mineralocorticoid receptor antagonist may be a steroidal or non-steroidal compound, and may be a spirolactone, in which the structural feature of the cyclic ester is spiro-linked to another ring system. Non-limiting examples of mineralocorticoid receptor antagonists include spironolactone, eplerenone, canrenone, feinlierone, and pregnane propanone (mexrenone).

In some embodiments, the present disclosure provides a pharmaceutical composition comprising 2mg to 250mg of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the pharmaceutical composition comprises 2mg to 250mg, 5mg to 200mg, 10mg to 150mg, 15mg to 100mg, 20mg to 80mg, 25 to 75mg, 30 to 60mg, or 15mg to 45mg of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg of compound I, a deuterated derivative of compound I, compound I form a, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and optionally at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, or 60mg of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier.

In some embodiments, the present disclosure provides a pharmaceutical composition comprising 15mg of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 30mg of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 45mg of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 60mg of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 75mg of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and at least one pharmaceutically acceptable carrier.

In some embodiments, the present disclosure provides a pharmaceutical composition comprising 15mg of compound I form a and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 30mg of compound I form a and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 45mg of compound I form a and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 60mg of compound I form a and at least one pharmaceutically acceptable carrier. In some embodiments, the present disclosure provides a pharmaceutical composition comprising 75mg of compound I form a and at least one pharmaceutically acceptable carrier.

In some embodiments, the patient receiving compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or administered a pharmaceutical composition comprising the same, is in a fasted state. As used herein, a patient in the "fasted state" does not eat any food or beverage (except water) at least two hours prior to administration of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or a pharmaceutical composition comprising the same, and at least two hours after administration.

In some embodiments, the patient to whom compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or a pharmaceutical composition comprising same, is administered is in a fed state. As used herein, a patient in the "fed state" has not eaten any food or beverage (except water) for at least eight hours (e.g., at least ten hours) prior to beginning a meal and begins a meal within 30 minutes of administering compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or a pharmaceutical composition comprising the same and has eaten a full meal within 30 minutes or less. In some embodiments, no additional food is allowed to be consumed for at least two hours (e.g., four hours) after administration of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or a pharmaceutical composition comprising the same. In some embodiments, unrestricted water access may be initiated after administration of compound I, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, or a pharmaceutical composition comprising the same. In some embodiments, water may begin to be drunk indefinitely at least one hour after application. In some embodiments, the meal is a high fat meal, such as a meal containing about 800-1000 calories in total and containing about 500-600 calories from fat and/or 55-65 grams of fat. In some embodiments, the meal is a low fat meal, such as a meal having about 500-600 calories in total and having about 100-125 calories and/or 11-14 grams of fat from fat. In some embodiments, the meal is a medium fat meal, such as a meal containing about 500-600 calories in total and containing about 30-35% fat and/or about 20 grams of fat.

The pharmaceutical composition comprising compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, may further comprise at least one pharmaceutically acceptable carrier. In some embodiments, the at least one pharmaceutically acceptable carrier is selected from a pharmaceutically acceptable vehicle and a pharmaceutically acceptable adjuvant. In some embodiments, the at least one pharmaceutically acceptable is selected from pharmaceutically acceptable fillers, disintegrants, surfactants, binders, lubricants.

As used herein, "at least one pharmaceutically acceptable carrier" includes any and all solvents, diluents, other liquid vehicles, dispersing aids, suspending aids, surfactants, isotonicity agents, thickeners, emulsifiers, preservatives, solid binders, and lubricants suitable for the particular dosage form desired. Remington: the Science and Practice of Pharmacy, 21 st edition, 2005, D.B. Troy, editors, lippincott Williams & Wilkins, philadelphia and Encyclopedia of Pharmaceutical Technology, J.Swarbrick and J.C. Boylan editors, 1988-1999, marcel Dekker, new York disclose various carriers for formulating Pharmaceutical compositions and known techniques for preparing The same. Unless any conventional carrier is incompatible with the compounds of the present disclosure, such as by producing any undesirable biological effect or otherwise interacting in a deleterious manner with any other component of the pharmaceutical composition, its use is contemplated within the scope of the present disclosure. Non-limiting examples of suitable pharmaceutically acceptable carriers include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins (e.g., human serum albumin), buffer substances (e.g., phosphates, glycine, sorbic acid, and potassium sorbate), mixtures of saturated vegetable fatty acid partial glycerides, water, salts and electrolytes (such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, and zinc salts), colloidal silica, magnesium trisilicate, polyvinylpyrrolidone, polyacrylates, waxes, polyethylene-polyoxypropylene block polymers, lanolin, sugars (such as lactose, glucose, and sucrose), starches (such as corn starch and potato starch), celluloses and their derivatives (such as sodium carboxymethylcellulose, ethylcellulose, and cellulose acetate), powdered tragacanth, malt, gelatin, talc, excipients (such as cocoa butter and suppository waxes), oils (such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil, and soybean oil), glycols (such as propylene glycol and polyethylene glycol), esters (such as ethyl oleate and ethyl laurate), agar, buffering agents (such as magnesium hydroxide and aluminum hydroxide), flavoring agents, water-compatible, flavoring agents, saline, flavoring agents (such as sodium lauryl sulfate), preservatives, sodium lauryl phosphate, sodium phosphate, and nontoxic preservatives.

The pharmaceutical compositions described herein are useful for treating APOLI-mediated diseases, including APOL 1-mediated kidney diseases, such as FSGS and/or NDKD. In some embodiments, the pharmaceutical compositions described herein are useful for treating an APOL 1-mediated kidney disease. In some embodiments, the pharmaceutical compositions described herein can be used to treat FSGS. In some embodiments, the pharmaceutical compositions described herein can be used to treat NDKD.

Any suitable pharmaceutical formulation known in the art may be used in the composition comprising compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof. In some embodiments, the pharmaceutical composition employed in the therapies of the present disclosure is a tablet. In some embodiments, the tablet is suitable for oral administration.

In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and cellulose. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and croscarmellose sodium. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and sodium stearyl fumarate. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and lactose monohydrate. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof and hypromellose acetate succinate. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, cellulose, and croscarmellose sodium. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, cellulose, croscarmellose sodium, and lactose monohydrate. In some embodiments, pharmaceutical compositions of the present disclosure (including but not limited to tablets) comprise compound I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, cellulose, croscarmellose sodium, hypromellose acetate succinate, and lactose monohydrate. In some embodiments, a pharmaceutical composition of the present disclosure (including but not limited to a tablet) comprises compound I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, cellulose, croscarmellose sodium, lactose monohydrate, hypromellose acetate succinate, and sodium stearyl fumarate.

In some embodiments, the tablets comprising compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, optionally may further comprise a coating. In some embodiments, the tablet comprising compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, further comprises a coating comprising polyvinyl alcohol (PVA), polyethylene glycol (PEG), titanium dioxide, and talc, which is referred to herein as a "non-functional film coating. One exemplary embodiment of a tablet comprising 250mg of compound I, a deuterated derivative of compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, and further comprising a non-functional film coating is shown in table 2. Non-functional film coatings can be applied to tablets comprising compound I, compound I form a, deuterated derivatives of compound I, and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof using conventional tablet film coating methods.

Table 2. Exemplary tablets containing 15mg of compound I and a film coating.

Components	Function of component	Content (% w/w)	Amount per tablet (mg)
				Compound I	Active substance	15.00	15.00
Microcrystalline cellulose	Diluent	78.50	78.50
				Croscarmellose sodium	Disintegrating agent	3.90	3.90
Stearyl sodium fumarate	Lubricant agent	2.60	2.60
				Total of	-	100.00	100.00

In some embodiments, disclosed herein are methods of treating, lessening the severity of, or symptomatically treating an APOL 1-mediated disease, including an APOL 1-mediated renal disease such as FSGS and/or NDKD, in a patient comprising administering to a patient suffering from FSGS or NDKD an effective amount of compound I, compound I form a, a deuterated derivative of compound I and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof as disclosed herein; or a pharmaceutical composition comprising compound I, compound I form a, a deuterated derivative of compound I, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

Non-limiting embodiments of the present disclosure include:

1. a method of treating an APOL 1-mediated disease, the method comprising administering to a patient in need thereof compound I:

a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof and in a daily amount of 2mg to 100 mg.

2. The method of embodiment 1, wherein said APOL1 mediated disease is an APOL1 mediated kidney disease.

3. The method of embodiment 2, wherein the APOL 1-mediated kidney disease is APOL 1-dependent Focal Segmental Glomerulosclerosis (FSGS).

4. The method of embodiment 2, wherein said APOL 1-mediated kidney disease is non-diabetic kidney disease (NDKD).

5. The method according to any one of embodiments 1-4, wherein the patient has the APOL1 genotype.

6. The method according to any one of embodiments 1-4, wherein the patient has nephropathy range proteinuria.

7. The method according to any one of embodiments 1-4, wherein the patient does not have nephrotic range proteinuria.

8. The method according to any one of embodiments 1 to 7, wherein compound I, deuterated derivatives thereof and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof is administered in a daily amount of from 5mg to 200mg, from 10mg to 150mg, from 15mg to 100mg, from 20mg to 80mg, from 25mg to 75mg, from 30mg to 60mg or from 15mg to 45 mg.

9. The method according to any one of embodiments 1 to 7, wherein compound I, deuterated derivatives thereof and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof is administered in a daily amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg or 100 mg.

10. The method according to any one of embodiments 1 to 9, wherein compound I, its deuterated derivative and/or the pharmaceutically acceptable salt of compound I or its deuterated derivative is administered in a daily amount of 15mg or 45 mg.

11. The method according to any one of embodiments 1-10, wherein compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered once daily or multiple times daily.

12. The method according to any one of embodiments 1-10, wherein compound I, its deuterated derivative and/or the pharmaceutically acceptable salt of compound I or its deuterated derivative is administered once every 24 hours (q 24 h).

13. The method according to any one of embodiments 1-12, wherein said method comprises administering compound I or a deuterated derivative thereof.

14. The method according to any one of embodiments 1-12, wherein said method comprises administering a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

15. The method according to any one of embodiments 1-14, wherein compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is comprised in a pharmaceutical composition.

16. The method according to embodiment 15, wherein the pharmaceutical composition is a tablet.

17. The method according to embodiment 16, wherein the tablet is suitable for oral administration.

18. The method according to embodiment 17, wherein said tablet for oral administration comprises 15mg of compound I.

19. The method according to any of embodiments 16-18, wherein the tablet comprises cellulose, croscarmellose sodium and/or sodium stearyl fumarate.

20. The method of embodiment 19, wherein the tablet further comprises a coating comprising polyvinyl alcohol (PVA), polyethylene glycol (PEG), titanium dioxide, and talc.

21. The method according to any one of embodiments 1-20, wherein the patient is in a fasted state.

22. The method according to any one of embodiments 1-20, wherein said patient is in a fed state.

23. The method according to any one of embodiments 1-22, wherein compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with one or more therapeutic agents selected from the group consisting of: angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), sodium-glucose cotransporter-2 (SGLT 2) inhibitors, renin inhibitors, enkephalinase inhibitors, immunosuppressants, and mineralocorticoid receptor antagonists.

23 A method according to embodiment 23, wherein the immunosuppressive agent is selected from tacrolimus, cyclosporine, mycophenolate mofetil and systemic corticosteroids.

24. The method according to embodiment 23 (a), wherein the systemic corticosteroid is prednisone or a prednisone equivalent.

25. The method according to any one of embodiments 1-22, wherein compound I, its deuterated derivatives and/or pharmaceutically acceptable salts of compound I or its deuterated derivatives are administered in combination with one or more therapeutic agents selected from the group consisting of: angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), renin inhibitors and prednisone equivalents.

26. The method according to any one of embodiments 1-22, wherein compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with an ACE inhibitor (ACEi) and an ARB.

27. The method according to any one of embodiments 1-22, wherein compound I, its deuterated derivative and/or the pharmaceutically acceptable salt of compound I or its deuterated derivative is administered in combination with ACEi, ARB and prednisone.

28. The method according to any one of embodiments 1-27, wherein the patient is not co-administered any immunosuppressive agent other than systemic corticosteroids, tacrolimus, cyclosporine, and mycophenolate mofetil.

29. The method of any one of embodiments 1-28, wherein compound I is substantially pure crystalline form a.

30. The method of any one of embodiments 1-28, wherein compound I is crystalline form a.

31. A pharmaceutical composition comprising 5mg to 200mg, 10mg to 150mg, 15mg to 100mg, 20mg to 80mg, 25 to 75mg, 30 to 60mg or 15mg to 45mg of compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

32. The pharmaceutical composition according to embodiment 31, wherein the composition comprises 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg or 100mg of compound I, a deuterated derivative thereof and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

33. A pharmaceutical composition according to embodiment 32, wherein the composition comprises 15mg of compound I.

34. A pharmaceutical composition according to embodiment 32, wherein the composition comprises 30mg of compound I.

35. A pharmaceutical composition according to embodiment 32, wherein the composition comprises 45mg of compound I.

36. A pharmaceutical composition according to embodiment 32, wherein the composition comprises 60mg of compound I.

37. A pharmaceutical composition according to embodiment 32, wherein the composition comprises 75mg of compound I.

38. The pharmaceutical composition of any one of embodiments 31 to 37, wherein compound I is substantially pure crystalline form a.

39. The pharmaceutical composition of any one of embodiments 31-37, wherein compound I is crystalline form a.

Example 1: synthesis of Compound I

Part A: synthesis of starting materials

Preparation S2

(3S, 4R) -3-amino-4-hydroxy-pyrrolidin-2-one (S2)

Step 1 Synthesis of (2S, 3R) -2, 4-dibromo-3-hydroxy-butyric acid methyl ester (C7)

Potassium (2R, 3R) -2,3, 4-trihydroxybutyrate, C6 (10g, 57.1mmol), and HBr/acetic acid (154g, 103mL, 30% w/w,570.8 mmol) were stirred for 16 hours. Anhydrous MeOH (250 mL) was added and the mixture was heated at reflux for 4 hours. The mixture was concentrated to dryness and the residue was dissolved in EtOAc (100 mL). The solution was washed with water (50 mL) and brine (50 mL), then Na ₂ SO ₄ Dried and concentrated in vacuo. Purification by silica gel chromatography (gradient: 15-20% EtOAc/hexanes) gave the product as a colorless liquid (13g, 83%). ¹ H NMR(400MHz，CDCl ₃ )δ4.71(d，J＝3.4Hz，1H)，4.17-4.14(m，1H)，3.82(s，3H)，3.53-3.44(m，2H)。

Alternative procedure for the synthesis of (2S, 3R) -2, 4-dibromo-3-hydroxy-butyric acid methyl ester (C7)

Potassium (2R, 3R) -2,3, 4-trihydroxybutyrate C6 (280 g) was stirred with a 33% HBr/acetic acid solution (1L) at room temperature for 24 h. The reaction mixture was then poured into MeOH (5L). The mixture was stirred at room temperature for 8 hours and then at 65 ℃ for 4 hours. The mixture was concentrated and the residue was dissolved in MeOH (1.2L) before concentrated sulfuric acid (30 mL) was added slowly. The mixture was heated at reflux for 6 hours and then concentrated. The residue was taken up in EtOAc (400 mL). The resulting solution was washed with water (250 mL), dried over Na2SO4, filtered and concentrated in vacuo to give the product as an oil that solidified upon storage at 4 ℃ (375g, 74%).

Step 2 Synthesis of (2R, 3S) -3- (bromomethyl) oxirane-2-carboxylic acid methyl ester (C8)

In a 12L round bottom flask equipped with an overhead stirrer, (2R, 3R) -2, 4-dibromo-3-hydroxy-butyric acid methyl ester C7 (524.8g, 1.9moL) was dissolved in acetone (4.5L). The reaction was cooled to 0 ℃ in an ice bath and Cs was added ₂ CO ₃ (994g, 3.1mol). The reaction was stirred at 0 ℃ for 30 minutes and then at room temperature for 2 hours. The mixture was filtered, washed with acetone, and then concentrated in vacuo to give a dark gray oil residue. Dissolving the product in CH ₂ Cl ₂ Filtering with short silica gel plug, and adding CH ₂ Cl ₂ (about 1L) elution. The filtrate was concentrated in vacuo to give the product as a clear yellow oil (377.3 g, quantitative). ¹ H NMR(300MHz，CDCl ₃ )δ3.83(s，3H)，3.71-3.61(m，2H)，3.61-3.53(m，1H)，3.46(dd，J＝9.9，6.6Hz，1H)ppm。 ¹³ C NMR(75MHz，CDCl ₃ )δ167.58，55.89，53.52，52.77，26.83ppm。

Step 2. Alternative procedure for the synthesis of (2R, 3S) -3- (bromomethyl) oxirane-2-carboxylic acid methyl ester (C8)

To a solution of (2R, 3R) -2, 4-dibromo-3-hydroxy-butyric acid methyl ester C7 (200g, 0.73mol) in acetone (2.0L) was added anhydrous K2CO3 (151.lg, 1.lm0l) while maintaining the reaction temperature at 0-5 ℃. The reaction was stirred at 0-5 ℃ for 2 hours and then allowed to warm gradually to room temperature over 4 hours. The reaction mixture was filtered and the filtrate was concentrated under reduced pressure. The residue was distilled under vacuum at 75-80 deg.C/200-300 Pa to give the product as a colorless liquid (105g, 74%).

Step 3 Synthesis of (2R, 3R) -3- (azidomethyl) oxirane-2-carboxylic acid methyl ester (C9)

In a 3L round bottom flask equipped with a magnetic stir bar, (2R, 3S) -3- (bromomethyl) oxirane-2-carboxylic acid methyl esterC8 (52.6 g,269.7 mmol) was dissolved in DMF (500 mL). Adding NaN ₃ (25.3g, 388.4 mmol) and the mixture is stirred at room temperature for 1 hour. The reaction was poured into water and extracted with EtOAc. The extract was washed with water and MgSO ₄ Dried and concentrated in vacuo to give a dark red oil. Dissolving the oil residue in CH ₂ Cl ₂ Filtering with silica gel plug, and adding CH ₂ Cl ₂ And (4) eluting. The filtrate was concentrated in vacuo to give the product as a clear pale red oil (40.8g, 96%). ¹ H NMR(300MHz，CDCl ₃ )δ3.87-3.74(m，3H)，3.67-3.55(m，2H)，3.47(dd，J＝13.3，5.1Hz，1H)，3.38(ddd，J＝6.3，5.0，4.4Hz，1H)。 ¹³ C NMR(75MHz，CDCl ₃ )δ167.76，54.81，52.67，51.32，48.74。

Step 4 Synthesis of (1R, 5R) -6-oxa-3-azabicyclo [3.1.0] hexan-2-one (C10)

A2L 3-neck flask with an overhead stirrer was charged with (2R, 3R) -3- (azidomethyl) oxirane-2-carboxylic acid methyl ester C9 (67g, 402.5mmol) in toluene (500 mL), stirred for 10 minutes, and then warmed to 80 ℃. Bu is mixed with ₃ SnH (220mL, 817.8mmol) and AIBN (2g, 12.2mmol) were dissolved in toluene (500 mL) and added to the reaction using an additional funnel over 3 hours. The resulting reaction mixture was stirred at 80-87 ℃ for 1 hour, then cooled to ambient temperature and concentrated under reduced pressure. The residue was partitioned between acetonitrile (2L) and pentane (1L), stirred for 10 minutes, and the acetonitrile phase was then separated (bottom). The acetonitrile phase was washed with pentane (2X 500 mL) and concentrated in vacuo to give a pale yellow solid. The solid residue was triturated with pentane (. About.200 mL) to give the product as a yellow solid which was used without further purification (52g, 98%). ¹ H NMR(300MHz，CDCl ₃ )δ5.89(s，1H)，4.00(q，J＝2.5Hz，1H)，3.74-3.50(m，2H)，3.44(dd，J＝12.4，2.4Hz，1H)。 ¹³ C NMR(75MHz，CDCl ₃ )δ173.24，53.28，52.18，44.00。

Step 5 Synthesis of (3S,4R) -3-amino-4-hydroxy-pyrrolidin-2-one (S2)

Will contain (1R, 5R) -6-oxa-3-azabicyclo [3.1.0]Hexane-2-one C10 (60g, 605.5 mmol)) And NH ₃ A (1.5L, 58.6 mol) Parr vessel was pressurized to 200psi and stirred at 18 ℃ for 2 days. Releasing NH from a vessel ₃ To provide a grey solid. Heptane was added and the mixture was stirred for 30 minutes. The solid was filtered, then the filter cake was separated, and then EtOAc and heptane were separated into the solid. The mixture was concentrated in vacuo to give the product (55g, 78%). ¹ H NMR(300MHz，D ₂ O)δ4.13(q，J＝7.2Hz，1H)，3.53(dd，J＝10.4，7.4Hz，1H)，3.36(d，J＝7.5Hz，1H)，3.05(dd，J＝10.4，6.8Hz，1H)。

Alternative preparation S2

(3S, 4R) -3-amino-4-hydroxypyrrolidin-2-one hydrochloride (S2)

Step 1 and 2. Synthesis of N-Boc- (3S, 4R) -3-amino-4-hydroxypyrrolidin-2-one (C12)

Ammonia was condensed into an autoclave containing a chilled solution of (2r, 3s) -3- (bromomethyl) ethylene oxide-2-carboxylic acid methyl ester C8 (81g, 0.42mol) in 1, 4-dioxane (160 mL) at-60 ℃ until approximately 400mL of liquid was collected. The autoclave was closed, allowed to gradually warm to room temperature, and then heated at 50-60 ℃ for 2 hours. The autoclave was then cooled back to-60 ℃ and depressurized. The reaction mixture was allowed to gradually warm to evaporate the liquid ammonia, leaving a viscous residue. The residue was taken up in MeOH (500 mL) and the suspension was treated with 28% sodium methoxide/MeOH solution (86g, 0.42mol). The mixture was stirred at room temperature for 30 minutes, then concentrated. The residue was dissolved in water (500 mL) and Na was added ₂ CO ₃ (89g, 0.84mol) and Boc ₂ A solution of O (110g, 0.5 mol) in THF (200 mL). The mixture was stirred at room temperature for 10 hours. The aqueous phase was then saturated with NaCl and extracted with THF (3X 200 mL). The organic phases were combined with Na ₂ SO ₄ Dried and concentrated in vacuo. The residue was triturated with warm MTBE (200 mL) and the precipitated solid was collected by filtration, washed with MTBE and dried in vacuo to give the product as a white solid (28 g, 31% yield).

Step 3 Synthesis of (3S, 4R) -3-amino-4-hydroxypyrrolidin-2-one hydrochloride (S2)

To a heated solution of N-Boc- (3S, 4R) -3-amino-4-hydroxypyrrolidin-2-one C12 (28g, 129mmol) in EtOH (300 mL) at 50-60 deg.C was added a solution of HCl in EtOH (5.0M, 75mL). The reaction mixture was kept at 50-60 ℃ for 2 hours. The suspension was cooled to room temperature and the solid was collected by filtration, washed with EtOH and dried in vacuo to give a solid (18g, 90%) as an off-white solid. ¹ H NMR(500MHz，DMSO-d6)δ8.73(brs，3H)，8.28(s，1H)，6.03(s，1H)，4.42-4.37(m，1H)，3.74(d，J＝6.8Hz，1H)，3.48-3.39(m，1H)，3.03-3.00(m，1H)。

Preparation S12

(3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] propionic acid) (S12)

Step 1.2 Synthesis of 4, 4-difluoro-6- [2- (4-fluorophenyl) ethynyl ] aniline (C49)

The method A comprises the following steps: sonagashira coupling method. To a flask containing 2, 4-difluoro-6-iodo-aniline C48 (134g, 525.5 mmol) was added NEt ₃ (1.3L) then DMF (250 mL), 1-ethynyl-4-fluoro-benzene (83.5g, 695.1mmol), cuI (20.5g, 107.6 mmol) and PdCl ₂ (PPh ₃ ) ₂ (25g, 35.6 mmol). The mixture was stirred at room temperature for 2 hours. The solvent was removed under reduced pressure and water (500 mL) was added. The mixture was extracted with ethyl acetate, filtered and concentrated in vacuo. The product mixture is filtered through a plug of silica gel (eluent: CH) ₂ Cl ₂ ) Then, a second silica plug filtration (eluent: 30-40% EtOAc/heptane). Silica gel chromatography (gradient: 0-20% EtOAc/heptane) afforded the product as a pale yellow solid (87g, 60%). ¹ H NMR(300MHz，CDCl ₃ )δ7.58-7.45(m，2H)，7.14-7.02(m，2H)，6.92(ddd，J＝8.8，2.8，1.7Hz，1H)，6.87-6.71(m，1H)，4.15(s，2H)。LCMS m/z 248.0[M+H] ⁺ 。

Step 2.5 Synthesis of 7-difluoro-2- (4-fluorophenyl) -1H-indole (C50)

The method B comprises the following steps: amine-alkyne cyclization process (CuI facilitated). To the reaction product of 2, 4-difluoro-6- [2- (4-fluorophenyl) ethynyl group]To a solution of aniline C49 (46g, 167.5 mmol) in DMF (600 mL) was added CuI (1.9g, 10.0 mmol) and the reaction was heated at reflux. Water (800 mL) was added and the mixture was extracted with MTBE. The mixture was then washed with saturated NaCl solution and Na ₂ SO ₄ Dried and then concentrated in vacuo to give the product, which was used in the next step without further purification (41g, 87%). ¹ H NMR(300MHz，CDCl ₃ )δ8.43(s，1H)，7.72-7.58(m，2H)，7.27-7.15(m，2H)，7.09(dd，J＝9.0，2.1Hz，1H)，6.85-6.63(m，2H)。LCMSm/z248.0[M+H] ⁺ 。

Step 3 Synthesis of methyl (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] prop-2-enoate ((C51)

The method C comprises the following steps: reductive alkylation method (TFA promoted). A12L flask equipped with an overhead stirrer was charged with 5, 7-difluoro-2- (4-fluorophenyl) -1H-indole C50 (300g, 1.2mol), CH ₂ Cl ₂ (3L), methyl 3, 3-dimethoxypropionate (195mL, 1.4 mol) and TFA (300mL, 3.9 mol). The reaction was heated to reflux for 4 hours. Adding additional CH ₂ Cl ₂ To facilitate stirring. After cooling to room temperature, the solid product was filtered using minimal CH ₂ Cl ₂ Washed and dried to give the product (388g, 96%). ¹ H NMR(400MHz，DMSO-d ₆ )δ12.66(s，1H)，7.77-7.57(m，4H)，7.56-7.37(m，2H)，7.19(ddd，J＝11.0，9.7，2.1Hz，1H)，6.47(d，J＝16.1Hz，1H)，3.69(s，3H)。LCMS m/z 332.4[M+H] ⁺ 。

Step 4.3 Synthesis of methyl- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] propionate (C52)

The method D comprises the following steps: pd (OH) ₂ Catalytic transfer hydrogenation. To (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl under a nitrogen atmosphere]To a suspension of methyl prop-2-enoate C51 (80g, 236.5 mmol) in EtOH (1.5L) was added Pd (OH) ₂ (6g 20. The w/w 8.5 mmol) and ammonium formate (160g, 2.5 mol). The mixture is heated under reflux for-3 hours, thenThe catalyst was removed by filtration. The filtrate was concentrated in vacuo to give the product as an off-white solid, which was used without further purification (82g, 100%). ¹ H NMR(300MHz，CDCl ₃ )δ8.18(s，1H)，7.65-7.47(m，2H)，7.27-7.14(m，2H)，7.14-7.00(m，1H)，6.76(ddd，J＝10.8，9.4，2.2Hz，1H)，3.65(s，3H)，3.27-3.04(m，2H)，2.75-2.49(m，2H)。LCMS m/z 334.3[M+H] ⁺ 。

Step 5.3 Synthesis of- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] propionic acid (S12)

The method E comprises the following steps: ester hydrolysis was performed with LiOH. To 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl]To a solution of methyl propionate C52 (217g, 651.lmmol) in THF (1L) and water (100 mL) was added LiOH (67g, 2.8mol). The mixture was heated at reflux for 2 hours and then cooled overnight. THF was removed by concentration under reduced pressure and water (about 1L) was added. The mixture was cooled on an ice bath and HCl (250mL, 11.7M,2.9 mol) was added to adjust the pH to 4. EtOAc (300 mL) was added and the aqueous layer was extracted with more EtOAc (100 mL). The organic extracts were combined and washed with sodium sulfate (Na) ₂ SO ₄ ) Dry, filter through a plug of silica gel, rinse with EtOAc. The filtrate was concentrated in vacuo to give an orange oil (50-75 mL). Heptane (50 mL) was added and the mixture was cooled on dry ice. A crystalline solid formed after stirring. The mixture was stirred on an ice bath until crystallization was complete. The solid was filtered, washed with heptane and air dried to give the product (208g, 96%). ¹ H NMR(300MHz，CDCl ₃ )δ8.15(s，1H)，7.60-7.46(m，2H)，7.27-7.15(m，2H)，7.09(dd，J＝9.1，2.2Hz，1H)，6.77(ddd，J＝10.8，9.4，2.2Hz，1H)，3.26-3.05(m，2H)，2.78-2.57(m，2H)。LCMS m/z 320.0[M+H] ⁺ 。

Alternative preparation S12

Step 3 Synthesis of methyl (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] prop-2-enoate (C51)

The reactor was charged with 5, 7-difluoro-2- (4-fluorophenyl) -1H-indole C50 (4.0kg, 16.5mol), CH ₂ Cl ₂ (37L) and methyl 3, 3-dimethoxypropionate (2.6L, 18.1mol) then TFA (3.9L, 5) was charged at ambient temperature1.0 mol). The resulting mixture was heated to reflux for 6 hours. The batch was then cooled to 20 ℃, n-heptane (2 vol) was added and filtered. The filter cake is dried in vacuum at 45 ℃ to obtain the product with the yield of 90 percent. ¹ H NMR(300MHz，DMSO-d ₆ )δ12.63(s，1H)，7.76-7.54(m，4H)，7.55-7.39(m，2H)，7.18(ddd，J＝11.1，9.7，2.2Hz，1H)，6.46(d，J＝16.1Hz，1H)，3.69(s，3H)。LCMS m/z 332.1[M+H] ⁺ 。

Reacting (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl]Methyl prop-2-enoate C51 (1.5 kg, 9.06mol) was slurried with THF (7L) in a container. Load Pd (OH) ₂ (10 g 20. Degree. W/w,. About.50% water, 0.014 mol). From the mixture with N ₂ Purge three times, then with H ₂ Purging once with H ₂ The vessel was pressurized to 50psi. The mixture was stirred at 20 ℃ until H ceased ₂ And (4) absorbing. After 1.5 hours, with N ₂ (. Times.3) purge mixture and filter by Solka-Floc, rinsing with THF (2 vol). The resulting filtrate was concentrated in vacuo at 45 deg.C (to 1.5 vol), charged with cyclohexane (1 vol), and concentrated again at 45 deg.C (to 1.5 vol). The slurry was cooled to 15-20 ℃ and filtered. The filter cake was then washed with cold cyclohexane (1 vol) and dried under vacuum at 45 ℃ to give the product in 95% yield.

To 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl]Methyl propionate C52 (9 kg, 27mmol) in a mixture of 2-MeTHF (54L, 6 vol) and MeOH (8.1L, 0.9 vol) was added 20% KOH (2 equiv, 54 mol). The mixture was stirred at 35 ℃ for 6 hours. The mixture was then vacuum distilled to 27L (3 vol) and cooled to 10-15 deg.C. Water (7.5L) and 2-MeTHF (16L) were added and the pH of the resulting biphasic mixture was adjusted to pH-2 with 6M HCl. The temperature was adjusted to 20 ℃ and the phases were separated. The organic phase is washed with water (15L) by

Filtered, rinsed with 2-MeTHF (18L, 2vol), and concentrated in vacuoShrink to 18L (2 vol). 18L (2 vol) n-heptane was added and the batch was again concentrated in vacuo to 18L (3 vol). The cycle was repeated again and the batch was seeded. 16L (1.8 vol) of n-heptane was added and the temperature was adjusted to 20 ℃. The slurry was stirred for 2 hours, filtered and the filter cake was washed with 2X 18L (2X 2 vol) of n-heptane. The filter cake is dried in vacuum at 45 ℃ to obtain the required product with the yield of 90 percent. ¹ H NMR(300MHz，CDCl ₃ )δ8.28(s，1H)，7.53(ddd，J＝8.7，5.4，2.8Hz，2H)，7.27-7.13(m，2H)，7.08(dd，J＝9.1，2.1Hz，1H)，6.76(ddd，J＝11.3，9.4，2.2Hz，1H)，3.91-3.69(m，4H)，3.28-3.07(m，2H)，2.79-2.53(m，2H)，2.00-1.74(m，3H)。LCMS m/z 320.4[M+H] ⁺ 。

And part B: synthesis of Compound (I)

Synthesis of 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] -N- [ (3S, 4R) -4-hydroxy-2-oxo-pyrrolidin-3-yl ] propionamide (I)

A2L 3-neck RB flask with magnetic stirrer, temperature probe and nitrogen inlet was charged with 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl in DMF (1.65L)]Propionic acid S12 (90.5g, 283.5 mmol) and (3S, 4R) -3-amino-4-hydroxy-pyrrolidin-2-one S2 (39.9g, 343.6 mmol) and stirred for 15 min. CDMT (61.1g, 348mmol) was added. The mixture was then cooled to-2 ℃ on an ice bath. N-methylmorpholine (131mL, 1.2 mol) was added dropwise over 20 minutes and the mixture was heated at 30 ℃ overnight. The reaction mixture was added to about 4.5L of ice water and extracted with EtOAc (1.2L. Times.4). The organic layers were combined and washed with 1.2L 1M HCl (. Times.3), then water (1.2L) and brine (1.2L). The organic layers were combined and washed with Na ₂ SO ₄ Dried, filtered and concentrated. The mixture was washed through a plug of silica gel (1.8L silica gel) eluting first with 25% EtOAc in dichloromethane (8L) to remove impurities, followed by hot EtOAc (8L) to elute the product. The EtOAc filtrate was concentrated in vacuo. TBME (400 mL) was then added and the mixture was stirred overnight. Filtering the obtained solid to obtain whiteProduct as a colored solid. 62g, 52%) ¹ H NMR(300MHz，CD ₃ OD)δ7.70-7.58(m，2H)，7.29-7.13(m，3H)，6.73(ddd，J＝11.1，9.6，2.2Hz，1H)，4.34(td，J＝7.6，6.8Hz，1H)，4.21(d，J＝7.8Hz，1H)，3.56(dd，J＝9.9，7.6Hz，1H)，3.20-3.04(m，3H)，2.65-2.53(m，2H)。LCMS m/z 418.2[M+H] ⁺ 。

Optical rotation: [ alpha ] to] _D ^20.7 = 14.01 (c =1.0, 10mg in 1mL MeOH).

Alternative procedure for the synthesis of Compound I

Step 1 Synthesis of methyl (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] prop-2-enoate (C51)

A solution of 5, 7-difluoro-2- (4-fluorophenyl) -1H-indole C50 (100g, 1.0 eq) in dichloromethane (850 mL,8.5 vol) was stirred at 22 ℃. Methyl 3, 3-dimethoxypropionate (63mL, 1.1 equiv.) was added followed by trifluoroacetic acid (96mL, 3.1 equiv.) and then rinsed with dichloromethane (25mL, 0.25vol). The batch is heated to 38 ℃ and stirred at this temperature. After 4 hours, the batch was cooled to 22 ℃ and n-heptane (200mL, 2vol) was added. The mixture was stirred at 22 ℃ for not less than 1 hour. The slurry was filtered and the reactor and filter cake were washed with n-heptane (1X 2vol (200 mL) and 1X 3vol (300 mL)). The resulting solid was dried under vacuum at 45 ℃ with a stream of nitrogen (nitrogen blanket) to give product C51 (127.7 g, 95% yield).

Step 2.3 Synthesis of methyl- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] propionate (C52)

Charging a hydrogenator with (E) -3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl]Methyl prop-2-enoate C51 (100.4g, 1.0 eq) then charged with Pd (OH) ₂ C (0.014 eq). Sealing the container and using N ₂ Three vacuum/purge cycles were performed. 2-MeTHF (2000mL, 20vol) was charged using residual vacuum and the resulting mixture was stirred at 22 ℃. Sealing the container and using N ₂ Three vacuum/purge cycles were performed, followed by hydrogen (H) ₂ ) A vacuum purge cycle was performed. The temperature was adjusted to 22 ℃ and 20psi H was used ₂ The vessel is pressurized. The mixture was stirred at 22 ℃ for 4 hours. With nitrogen gas N ₂ Is carried out three timesA vacuum/purge cycle. By passing

The batch was filtered through the pad and the filter cake was rinsed with 2-MeTHF (2X 300mL, 2X 3 vol). Combining the filtrates, placing under vacuum and distilling at 45.0 deg.C or lower to 2.0-3.0 total volume. The batch temperature was adjusted to 22 ℃ and n-heptane (1000mL, 10vol) was added to the vessel over at least 1 hour. Vacuum is applied and the filtrate is distilled at ≤ 45.0 deg.C to a total volume of 3.5-4.5. The slurry was cooled to 22 ℃ and stirred for not less than 1 hour. The slurry was filtered and the filter cake was washed with n-heptane (1X 1vol (100 mL) and 1X 0.5vol (50 mL)). The solid was dried under vacuum at 45 ℃ with a stream of nitrogen to give product C52 (91.9 g, 91% yield).

Step 3.3 Synthesis of- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] propionic acid (S12)

Reacting 3- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl]A mixture of methyl propionate C52 (80.0 g,1.0 eq.) and 2-MeTHF (480mL, 6 vol) was agitated at 22 ℃ and treated with methanol (72mL, 0.9vol). A solution of KOH (27.1g, 2.0 equiv.) in water (107mL, 1.3 vol) was added over about 20 minutes. The resulting mixture was heated to an internal temperature of 35 ℃ and stirred for 3 hours. The temperature was adjusted to 22 ℃. Vacuum was applied and the mixture was distilled at ≤ 45 deg.C to 3.0 total volume. The internal temperature was adjusted to 12 ℃. Water (64mL, 0.8vol) and 2-MeTHF (304mL, 3.8vol) were then added to the mixture. 6N HCl (75mL, 0.9vol) was added slowly to the mixture and stirred vigorously until the batch reached a pH < 3. The internal temperature was adjusted to 22 ℃, and the biphasic mixture was stirred for not less than 0.5 hours. Stirring was stopped and the phases were allowed to separate for not less than 0.5 hour. The lower aqueous phase was removed. Water (160mL, 2vol) was added to the reactor at 22 deg.C and the biphasic mixture was stirred for not less than 0.5 h. Stirring was stopped and the phases were allowed to separate over a period of not less than 0.5 hour. Removing the lower aqueous phase and passing

The pad filters the batch. The reactor and filter cake were flushed with 2-MeTHF (160mL, 2vol). Applying vacuum and distilling the combined filtrates to 2-3 total body at ≤ 40.0 deg.CAnd (4) accumulating. The vessel was charged with n-heptane (160mL, 2vol), vacuum was applied, and the filtrate was distilled at ≦ 40.0 deg.C to 2 total volumes (this step was repeated once more). Additional n-heptane (144mL, 1.8vol) was then added to the mixture. The internal temperature was adjusted to 40 ℃ and stirred for not less than 2 hours. It was used for a minimum of 5 hours to adjust the internal temperature to 22 ℃ and stir for not less than 16 hours. The slurry was filtered. The filter cake was washed with n-heptane (3X 40mL, 3X 0.5 vol). The solid was dried under vacuum at 45 ℃ with a stream of nitrogen to give the product S12 (72.6 g, 95% yield).

Step 4.3 Synthesis of- [5, 7-difluoro-2- (4-fluorophenyl) -1H-indol-3-yl ] -N- [ (3S, 4R) -4-hydroxy-2-oxo-pyrrolidin-3-yl ] propionamide (Compound I)

A mixture of S12 (50.0g, 1.0 eq), (3S, 4R) -3-amino-4-hydroxypyrrolidin-2-one hydrochloride, S2 (25.1g, 1.05 eq) and CDMT (30.3g, 1.1 eq) in DMF (250mL, 5vol) was stirred and cooled to 0 ℃. The reactor was charged with NMM (60mL, 3.5 equiv.) for not less than 1 hour while maintaining an internal temperature of 5 ℃ or less. The batch is stirred at-5 ℃ for not less than 1 hour. The batch was warmed to 22 ℃ over at least 1 hour and stirred at 22 ℃ for 16 hours. The batch was cooled to 0 ℃. Water (250mL, 5 vol) was added while maintaining an internal temperature < 20 ℃. To the mixture was added a 90/10 mixture of EtOAc/IPA (1000mL, 20vol). 6N HCl (40mL, 0.8vol) was then added while maintaining an internal temperature < 10 ℃ until a pH of 1-3 was reached. The internal temperature was adjusted to 22 ℃ and the biphasic mixture was stirred for not less than 0.5 h. Stirring was stopped and the phases were allowed to separate for not less than 0.5 hour. The lower aqueous phase was removed. The aqueous layer was back-extracted with a 90/10 mixture of EtOAc/IPA (2X 250mL, 2X 5 vol) at 22 ℃. The organic phases from the extractions were combined, washed with water (5X 500mL, 5X 10 vol) at 22 ℃ with mixing for not less than 0.5 hour and settling for not less than 0.5 hour per wash. The batch was polish filtered. Vacuum was applied and the organic phase was distilled at < 50 ℃ to a total volume of 9.5-10.5. EtOAc (500mL, 10vol) was added to the mixture, vacuum was applied, and the organic phase was distilled at < 50 ℃ to a total volume of 9.5-10.5 (this step was repeated once more). To the mixture was added EtOAc (300mL, 6 vol) and n-heptane (200mL, 4 vol). The resulting slurry was heated to 50 ℃ and stirred for not less than 17 hours. The mixture was then cooled to 22 ℃ over 2 hours and stirred for not less than 1 hour. The slurry was filtered. The filter cake was washed with 1: 1 EtOAc/n-heptane (2X 150mL, 2X 3 vol). The solid was dried under vacuum at 45 ℃ or below with a stream of nitrogen to give compound I (52.6 g, yield 80%).

Recrystallization of Compound I

The reactor was charged with Compound 2 (37.6 g,1.0 eq) followed by a 3: 1 mixture of IPA/water (240mL, 6.4 vol). The slurry was heated to an internal temperature of 75 ℃. The batch was cooled to an internal temperature of 55 ℃ and stirred at this temperature for at least 0.5 hour. This batch was seeded with a 0.5 wt% previously generated batch of compound 2 as a suspension in a 3: 1 mixture of IPA/water (4 ml,0.1 vol). The mixture was stirred at 55 ℃ for not less than 1.5 hours. Water (218mL, 5.8 vol) was added while maintaining the temperature at 55 ℃ for a minimum of 5 hours. It took not less than 5 hours to cool the slurry to 22 ℃ and stir not less than 2 hours. The slurry was filtered. The filter cake was washed with 2: 3 IPA/water (2X 114mL, 2X 3 vol). The solid was dried under vacuum at ≤ 45 deg.C under a stream of nitrogen to give compound I (34.5 g, 92% yield).

Compound I form A

The reactor was charged with 12.3kg of compound I followed by a 3: 1 adduct of 2-propanol/water. Agitation was started and the mixture was heated to 75 ℃ to achieve complete dissolution. It took 1 hour to cool the mixture to 55 ℃ and stir at this temperature for 30 minutes. Agitation was continued for 1.5 hours. Water (5.8 vol) was added at 55 ℃ over 5 hours, after which the mixture was cooled to 22 ℃ over 6 hours. The mixture was stirred at 22 ℃ for 2 hours and then filtered under vacuum. The resulting wet cake was washed with a 3: 1 mixture of 2-propanol/water (2.74 vol. Times.2) and dried in vacuo. The wet cake was further dried under vacuum with a nitrogen stream at 45 ℃ to give 11.2kg of form a.

X-ray powder diffraction of Compound I form A

A powder X-ray powder diffraction pattern of compound I form a was obtained at room temperature using a PANalytical Empyrean diffractometer equipped with a PIXcel 1D detector (fig. 1). The peaks are listed in table 11 below.

TABLE 3 list of peaks from powder X-ray powder diffraction pattern of form A

Solid state NMR of Compound I form A

With the following parameters: 12.5kHz rotation; reference adamantane 29.5ppm, obtaining Compound I form A at 275K ¹³ C CPMAS (fig. 2). The peaks are listed in table 12 below. The carbon peaks highlighted in bold are unique to form a relative to the following forms: hydrate a, hydrate C and amorphous form.

TABLE 4 from form A ¹³ Peak list for C CPMAS

Example 3: preparation of coated tablets containing 15mg of Compound I

The following materials may be used in this exemplary preparation of tablets containing 15mg of compound I, as shown in table 3.

Table 5. Exemplary tablets containing 15mg of compound I.

In this exemplary preparation, compound I and the inner addition microcrystalline cellulose and croscarmellose sodium were screened, combined in a box blender, and blended. The sieved sodium endocellyl fumarate was added to the box blender and the mixture blended. The mixture is then dry granulated and milled to form milled granules. These milled granules were fed into a box blender and then screened plus microcrystalline cellulose and screened plus croscarmellose sodium were added thereto. The mixture was blended. The sieved additional sodium stearyl fumarate was added to the box blender and the mixture was blended. The resulting blend is discharged and then loaded into a tablet press. The blend was compressed into tablets and then discharged. A non-functional film coating is optionally applied to the tablets comprising compound I using conventional tablet film coating methods.

Example 4: efficacy of Compound I in the treatment of APOL 1-mediated focal segmental glomerulosclerosis

Inclusion criteria for phase 2, open label, one arm, part 2 study of compound I:

1. participants were between 18 and 65 years of age inclusive;

2. the Body Mass Index (BMI) of the participants was 18.0 to 40.0kg/m ² (iv) and a total body weight > 50kg;

3. participants were diagnosed with FSGS by renal biopsy, except for top variant (tip variant), as confirmed by the eligibility procedure;

4. the APOL1 genotype of the participants was G1/G1, G2/G2 or G1/G2, as determined by clinical studies, which can be confirmed by Sanger sequencing;

5. during the screening period, participants had a UPCR ratio of ≧ 3g/g and < 10g/g (cohort 1) or ≧ 1g/g and < 2.7g/g (cohort 2) at the first micturition in the morning for 3 measurements taken on at least 3 independent days over a 7-day period (all 3 measurements must meet this criterion);

6. according to the formula of epidemiological cooperation research (CKD-EPI) of chronic kidney diseases, the participants have the concentration of more than or equal to 45mL/min/1.73m ² (cohort 1) estimated glomerular filtration Rate (eGFR) or ≥ 30mL/min/1.73m ² eGFR of (queue 2); eGFR is more than or equal to 30 and less than 40mL/min/1.73m ² The participant of (a) must have renal tubule interstitial fibrosis of < 50% or be described as none, mild or moderate in renal biopsy (cohort 2); and

7. from 28 days prior to screening to the follow-up period, the participants did not plan to start, stop or modify the administration of Angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), enkephalinase inhibitors, sodium-glucose cotransporter-2 (SGLT 2) inhibitors, renin inhibitors, systemic corticosteroids, tacrolimus or mycophenolate esters.

8. Participants who used low doses of corticosteroids (< 10 mg/day prednisone or prednisone equivalents) or allowed immunosuppressive agents (e.g., tacrolimus or mycophenolate mofetil) had to maintain a stable dose for 28 days prior to screening.

The clinical trial contained two cohorts. Cohorts 1 and 2 allowed the administration of stable low doses of systemic corticosteroids (< 10 mg/day of prednisone or prednisone equivalent), tacrolimus and mycophenolate mofetil, but no other immunosuppressive agents were allowed. The target and dosing schedules for cohort 1 and cohort 2 were the same.

Initially, participants received screening assessments and provided informed consent during a 28 day screening period. Screening assessments include, but are not limited to, vital sign analysis, height and weight, electrocardiographic measurements, serum chemistry, UPCR (ratio of urine protein to creatinine), and the like. The at-risk allelic state (APOL 1 genotype) is assessed at any time prior to initiation of treatment (e.g., during screening).

All participants received a dose of 15mg q24h for 2 weeks and thereafter a dose of 45mg q24h for 11 weeks. After the last dose, participants were followed up to 12 weeks to evaluate proteinuria after treatment discontinuation. Participants who discontinued compound I administration in advance scheduled an early treatment termination visit as soon as possible after deciding to terminate study medication; these participants continued to complete all other planned study visits to assess efficacy (i.e., UPCR (ratio of urine protein to creatinine), UACR (ratio of urine albumin to creatinine)) until the last follow-up was completed. Participants were followed monthly for up to 12 weeks or until the UPCR returned to baseline, whichever occurred first, after the last dose of study drug. All subjects completed a safety follow-up 28 (± 7) days after the last dose of study drug.

Proteinuria was assessed at multiple time points throughout the treatment and follow-up period. The time points for the primary analysis were day 1 and week 13.

Study participants included male and female subjects diagnosed with FSGS and confirmed the APOL1 genotype. Participants received a dose of compound I of 15mg q24h for 2 weeks and 45mg q24h for 11 weeks.

The primary endpoint for assessing effect on FSGS was the percent change in UPCR from baseline at week 13. As used herein, a "baseline value" is the most recent measurement (planned or unplanned) taken prior to the first dose of study drug. For ECG, baseline values were defined as the average of pre-treatment measurements (triplicates) prior to the first dose of compound I. The "change from baseline (absolute change)" is calculated as the post-baseline value minus the baseline value. The "change from baseline" is calculated and expressed as a percentage, i.e., 100% × (post-baseline value minus baseline value)/baseline value.

Example 5: efficacy of Compound I in the treatment of APOL 1-mediated non-diabetic Kidney disease

Inclusion criteria for phase 2, double-blind, placebo-controlled, dose-ranging studies of compound I:

1. participants were between 18 and 60 years of age inclusive;

2. participants had Body Mass Index (BMI) of 18.0 to 40.0kg/m ² (iii) and a total body weight > 50kg;

3. the APOL1 genotype of the participants is G1/G1, G2/G2 or G1/G2, and is obtained by clinical research and determination;

4. during the screening period, participants had UPCR ratios of ≧ 0.2g/g and < 3g/g at the first urination in the morning for 3 measurements taken on at least 3 independent days over a 7-day period (all 3 measurements must meet this criteria);

5. according to the formula of epidemiological cooperation research (CKD-EPI) of chronic kidney disease, the participants have the dosage of more than or equal to 30mL/min/1.73m ² Glomerular Filtration Rate (GFR); and

6. during the treatment period, the participants did not plan to start, stop or modify the administration of Angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), enkephalinase inhibitors, sodium-glucose cotransporter-2 (SGLT 2) inhibitors or renin inhibitors.

7. Participants who have a history of hypertension and currently receive a stable dose (at least 4 weeks) of antihypertensive medication.

Initially, participants received screening assessments and provided informed consent over a 28 day screening period. Screening assessments include, but are not limited to, vital sign analysis, height and weight, electrocardiographic measurements, serum chemistry, UPCR (ratio of urine protein to creatinine), and the like. The at-risk allelic state (APOL 1 genotype) is assessed at any time prior to initiation of treatment (e.g., during screening).

Participants will be randomly assigned to receive a dose of compound I or placebo. Participants will receive low, medium or high doses of compound I13 weeks thereafter. The dose of compound I will be determined prior to the start of the study using available data from clinical and non-clinical studies. Participants who discontinued compound I administration in advance scheduled an early treatment termination visit as soon as possible after deciding to terminate study medication; these participants continued to complete all other planned study visits to assess efficacy (i.e., UPCR (ratio of urine protein to creatinine), UACR (ratio of urine albumin to creatinine)) until the last follow-up was completed. All subjects completed a safety follow-up 28 (± 7) days after the last dose of study drug.

Study participants included male and female subjects with confirmed APOL1 genotype and no diabetic/autoimmune nephropathy. Participants received either a placebo or a low, medium or high dose of compound I for 13 weeks.

The primary endpoint for assessing the effects on APOL 1-mediated non-diabetic kidney disease was the percent change in UPCR at week 13 from baseline. As used herein, a "baseline value" is the average of the 3 screening UPCR values used to qualify. The primary analysis will be based on a mixed effects model (MMRM) with repeated measurements and the change from baseline as a dependent variable.

The foregoing discussion discloses and describes merely exemplary embodiments of the present disclosure. One skilled in the art will readily recognize from such discussion, and from the accompanying drawings and claims, that various changes, modifications and variations can be made therein without departing from the spirit and scope of the disclosure as defined in the following claims.

Claims

1. A method of treating an APOL1 mediated disease comprising administering to a patient in need thereof compound I:

2. The method of claim 1, wherein the APOL 1-mediated disease is an APOL 1-mediated kidney disease.

3. The method of claim 2, wherein the APOL 1-mediated kidney disease is APOL 1-dependent Focal Segmental Glomerulosclerosis (FSGS).

4. The method of claim 2, wherein the APOL 1-mediated kidney disease is non-diabetic kidney disease (NDKD).

5. The method of any one of claims 1-4, wherein the patient has an APOL1 genotype.

6. The method of any one of claims 1-4, wherein the patient has nephrotic range proteinuria.

7. The method of any one of claims 1-4, wherein the patient does not have nephrotic range proteinuria.

8. The method of any one of claims 1-7, wherein compound I, deuterated derivatives thereof, and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof, is administered in a daily amount of from 5mg to 200mg, from 10mg to 150mg, from 15mg to 100mg, from 20mg to 80mg, from 25mg to 75mg, from 30mg to 60mg, or from 15mg to 45 mg.

9. The method of any one of claims 1-7, wherein compound I, deuterated derivatives thereof, and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof is administered in a daily amount of 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100 mg.

10. The method of any one of claims 1-9, wherein compound I, deuterated derivatives thereof and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof is administered in a daily amount of 15mg or 45 mg.

11. The method of any one of claims 1-10, wherein compound I, its deuterated derivative and/or the pharmaceutically acceptable salt of compound I or its deuterated derivative is administered once daily or multiple times daily.

12. The method of any one of claims 1-10, wherein compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, is administered once every 24 hours (q 24 h).

13. The method of any one of claims 1-12, wherein the method comprises administering compound I or a deuterated derivative thereof.

14. The method of any one of claims 1-12, wherein the method comprises administering a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

15. The method of any one of claims 1-14, wherein the compound I, deuterated derivatives thereof, and/or pharmaceutically acceptable salts of compound I or deuterated derivatives thereof are contained in a pharmaceutical composition.

16. The method of claim 15, wherein the pharmaceutical composition is a tablet.

17. The method of claim 16, wherein the tablet is suitable for oral administration.

18. The method according to claim 17, wherein the tablet for oral administration comprises 15mg of compound I.

19. The method of any one of claims 16-18, wherein the tablet comprises cellulose, croscarmellose sodium, and/or sodium stearyl fumarate.

20. The method of claim 19, wherein the tablet further comprises a coating comprising polyvinyl alcohol (PVA), polyethylene glycol (PEG), titanium dioxide, and talc.

21. The method of any one of claims 1-20, wherein the patient is in a fasted state.

22. The method of any one of claims 1-20, wherein the patient is in a fed state.

23. The method of any one of claims 1-22, wherein compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, is administered in combination with one or more therapeutic agents selected from the group consisting of: angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), sodium-glucose cotransporter-2 (SGLT 2) inhibitors, renin inhibitors, enkephalinase inhibitors, systemic corticosteroids, tacrolimus, cyclosporine, mycophenolate esters, and mineralocorticoid receptor antagonists.

24. The method of claim 23, wherein the systemic corticosteroid is prednisone or a prednisone equivalent.

25. The method of any one of claims 1-22, wherein compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof, is administered in combination with one or more therapeutic agents selected from: angiotensin Converting Enzyme (ACE) inhibitors, angiotensin Receptor Blockers (ARBs), renin inhibitors, and prednisone equivalents.

26. The method of any one of claims 1-22, wherein compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with an ACE inhibitor (ACEi) and an ARB.

27. The method of any one of claims 1-22, wherein compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof is administered in combination with ACEi, ARB, and prednisone.

28. The method of any one of claims 1-27, wherein the patient is not co-administered any immunosuppressive agent other than a systemic corticosteroid, tacrolimus, cyclosporine, and mycophenolate mofetil.

29. The process of any one of claims 1-28, wherein compound I is substantially pure crystalline form a.

30. The method of any one of claims 1-28, wherein compound I is crystalline form a.

32. The pharmaceutical composition of claim 31, wherein the composition comprises 2mg, 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, or 100mg of compound I, a deuterated derivative thereof, and/or a pharmaceutically acceptable salt of compound I or a deuterated derivative thereof.

33. The pharmaceutical composition according to claim 32, wherein the composition comprises 15mg of compound I.

34. The pharmaceutical composition according to claim 32, wherein the composition comprises 30mg of compound I.

35. The pharmaceutical composition according to claim 32, wherein the composition comprises 45mg of compound I.

36. The pharmaceutical composition according to claim 32, wherein the composition comprises 60mg of compound I.

37. The pharmaceutical composition according to claim 32, wherein the composition comprises 75mg of compound I.

38. The pharmaceutical composition according to any one of claims 31-37, wherein compound I is substantially pure crystalline form a.

39. The pharmaceutical composition according to any one of claims 31-37, wherein compound I is crystalline form a.